Monday, April 23, 2012

When Health Care is Promoted As "Free"

Health expenditures in the United States neared $2.6 trillion in 2010, over ten times the $256 billion spent in 1980. The rate of growth in recent years has slowed relative to the late 1990s and early 2000s, but is still expected to grow faster than national income over the foreseeable future.

So imagine my surprise when I saw this Medicare commercial last night that stated preventative health care services provided by Medicare were "free:"

CMS also uses the word "free" in the description of the new health care law's provisions on their Youtube channel:

"For those with Medicare, the health care law offers most preventive health care services for free."

Describing health care services as "free" dissociates people the cost reality of providing these services. It perpetuates the myth that we can have health care services without having to pay for them. Further, calling services "free" devalues the expertise and cost of facilities and regulatory oversight required to support such services.

Of course, public policy experts who promote these deceptive advertising techniques argue that these ads are justified because they encourage people to participate in preventative health services, thereby saving costs. But where are the data that these ads really work? Scientists know the realities of indeterminate, false positive and false negative testing of any screening test. We know the huge costs of additional testing that occurs in such in instance. Given our overriding health care cost concerns, should we not insist on proof of the cost-effectiveness of such a large-scale, national approach to preventive medicine services rather blithely assuming it works?

After all, the reality of health care today is that it is anything but "free."

5 comments:

"Of course, public policy experts who promote these deceptive advertising techniques argue that these ads are justified because they encourage people to participate in preventative health services, thereby saving costs. "

Their whole careers and phony baloney jobs are based on lies that they know are lies. Why do you expect them to do anything different. Isn't. Going. to. Happen. Ever.

I am surprised that you still have time to engage in social media. I guess that will change this summer when Aetna begins their idea of screening i.e. prescreening/precertification. Wes, for all your hard work, dedication, unreimbursed efforts, etc, etc. It will be necessary for you to speak with a "peer" prior to placing a PPM, ICD, CRT. Forget about blogging or even seeing your family. Just tell your nurse to pull you out of a room when your "peer" comes to the phone.

This will be the best way to cut back on all the fraud. Expect the other companies to begin similar programs once the success of this one is realized.

I've been arguing against the idea that so called "prevention and wellness" strategies will save money for years to no avail. It's ingrained in the conventional wisdom and can't be shaken. The ads are deceptive in another way, they don't explain to patients that when their screening require follow up, all those furthur studies are not covered with no out of pocket costs. So a "free" screening can wind up costing you plenty.

Dr. Wes. I so liked your post that I added an exerpt to a collection of the best posts I've seen recently on my site. http://drpullen.com/highgive1-1You may want to let your followers know you are appreciated. Thanks. Ed

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About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.